Life Chelsea,  Skrivanek Jordan,  Tung Eric,  Chow Jeanne

Final Pr. ID: Poster #: SCI-020

To develop a reproducible framework for designing subspecialty pediatric radiology curricula. Read More

Authors:  Life Chelsea , Skrivanek Jordan , Tung Eric , Chow Jeanne

Keywords:  Education, Curriculum, Quality Improvement

Moon John,  Li Hanzhou,  Yang Ling,  Yang Yinghua,  Kadom Nadja

Final Pr. ID: Poster #: SCI-011

To evaluate and quantify the use of uncertainty language in pediatric radiology report impressions, focusing on variation of uncertainty by modality, patient demographics, and care setting. Read More

Authors:  Moon John , Li Hanzhou , Yang Ling , Yang Yinghua , Kadom Nadja

Keywords:  Radiologist Reporting Styles, Quality Improvement, Language

Ravi Shweta,  Riedesel Erica,  Kaplan Summer

Final Pr. ID: Poster #: SCI-016

Clinical decision support (CDS) may positively affect patient care in radiology by encouraging high-value imaging, usually via society guidelines. Given recent national initiatives for high-value imaging, imaging-related CDS was deployed by many hospital systems. Existing studies show modest reduction in low-utility imaging following CDS implementation. With the adoption of pediatric-specific imaging guidelines at our institution, we seek to evaluate the direct impact of CDS on clinician orders, particularly in the emergency department (ED). Read More

Authors:  Ravi Shweta , Riedesel Erica , Kaplan Summer

Keywords:  Quality Improvement, Dashboards, Clinical Pathway

Shah Summit,  Mcgonagill Phillip,  Hu Houchon,  Sankaran Akila,  Krishnamurthy Rajesh,  Krishnamurthy Ramkumar

Final Pr. ID: Poster #: SCI-030

The likelihood of sedation for an MRI exam in a patient under 8 years is high. Disadvantages of sedation usage include direct complications, suspected long-term effects, and higher costs. Sedation reduction techniques include the use of an MRI simulator, accelerated MRI scans, abbreviated protocols, and swaddle and sleep techniques. We evaluated the clinical image quality and cost effectiveness associated with an MRI simulator training program. Read More

Authors:  Shah Summit , Mcgonagill Phillip , Hu Houchon , Sankaran Akila , Krishnamurthy Rajesh , Krishnamurthy Ramkumar

Keywords:  MRI Sedation, Quality Improvement, Cost

Iles Benjamin,  Samora Julie,  Singh Satbir,  Ruess Lynne

Final Pr. ID: Poster #: SCI-035

Treatment pathways for isolated distal radius fractures in children are evolving and becoming more tailored to specific fracture types, including different management plans for stable buckle fractures (BFs) versus unstable distal radius fractures (DRFs). We propose a measurement rule to aid differentiation of stable BFs from unstable DRFs in children.
Read More

Authors:  Iles Benjamin , Samora Julie , Singh Satbir , Ruess Lynne

Keywords:  Quality Improvement, Radiography, Children

Ruess Lynne,  Samora Julie

Final Pr. ID: Poster #: SCI-026

To test radiographic diagnostic accuracy for distinguishing between stable distal radius buckle fractures (BF) from other distal radius fractures (DRF) after introducing a measurement guideline.
Background: Management of pediatric forearm fractures has become fracture specific, as treatment of the common stable BF is trending toward home management with a removable wrist splint while other potentially unstable, DRF require immobilization and orthopaedic follow-up. Diagnostic accuracy between BF and DRF is therefore imperative. We developed and suggested our radiologists use a measurement guideline to aid diagnosis with this general rule: an isolated distal radius fracture in a child > 7y is not likely to be a BF if the fracture-to-physis distance is < 1 cm. Read More

Authors:  Ruess Lynne , Samora Julie

Keywords:  Quality Improvement, fracture, radiography

Shoaib Navaira,  Rigsby Devyn,  Patrick Lenehan,  Clark Kendall,  Gallo Sebastian,  Egan Natalie,  Victoria Teresa,  Gee Michael,  Sagar Pallavi

Final Pr. ID: Poster #: SCI-015

To evaluate the usability, workflow impact, and communication effectiveness of an asynchronous electronic consultation (e-Consult) platform implemented within pediatric radiology department. The platform was assessed from the perspectives of both pediatric care providers and radiologists following its integration at a tertiary academic medical center. Read More

Authors:  Shoaib Navaira , Rigsby Devyn , Patrick Lenehan , Clark Kendall , Gallo Sebastian , Egan Natalie , Victoria Teresa , Gee Michael , Sagar Pallavi

Keywords:  Consult, Workload, Quality Improvement

Parmar Sweta,  Liu Ray,  Larsen Ethan,  Macon Reyna,  Nigro Alessandria,  Silvestro Elizabeth,  Anupindi Sudha

Final Pr. ID: Poster #: EDU-009

Reading Room Coordinators (RRCs) are crucial for radiology department operations. Studies have shown the positive impact of RRCs in improving workflow efficiency for radiologists. Despite their critical role in facilitating communication and minimizing disruptions to radiologists’, RRCs often experience significant workflow interruptions, primarily due to constant phone calls and multitasking demands. Our practice’s RRCs receive ~7700 inbound calls per week in addition to all outbound calls, emails, and legal requests. These interruptions may impact radiologists, radiology operations, other hospital departments, and patients and families downstream. We examined the barriers affecting RRC workflow using the SEIPS (Systems Engineering Initiative for Patient Safety) framework from human factors (HF). We implemented interventions to overcome those barriers to increase efficiency, reduce interruptions, and improve the work environment. Read More

Authors:  Parmar Sweta , Liu Ray , Larsen Ethan , Macon Reyna , Nigro Alessandria , Silvestro Elizabeth , Anupindi Sudha

Keywords:  Workload, Wellness, Improvement

Sousae Sean,  Simmons Curtis,  Bailey Smita,  Cutler Kayci,  Youssfi Mostafa,  Reynolds Kristine,  Oliver Clay,  Pfeifer Cory

Final Pr. ID: Poster #: SCI-006

Growth in our hospital has resulted in multiple new locations opening which has resulted in staffing by ultrasound technologists lesser experienced in appendicitis imaging. Likewise, our ordering providers have increased their push to reduce CT utilization. Our aim was to improve the appendix visualization frequency by 10% over 6 months to reduce exposure to ionizing radiation, reduce cost for families, lower risk to patients, reduce length of stay in the emergency department, and shorten the time to diagnosis. Read More

Authors:  Sousae Sean , Simmons Curtis , Bailey Smita , Cutler Kayci , Youssfi Mostafa , Reynolds Kristine , Oliver Clay , Pfeifer Cory

Keywords:  Appendicitis, Quality Improvement, Ultrasound

Givler Nicole,  Gouge Laura,  Vogel Daniel,  Averill Lauren

Final Pr. ID: Poster #: SCI-012

For patients who had implants placed at our hospital, we found missing documentation when patients presented for imaging procedures. Lack of documentation led to patient safety concerns and time needed to research implants. Using continuous improvement (CI) methods, we aimed to eliminate instances of missing make, model, & manufacturer (3M) information in the EMR for patients recovering in the PACU after an implant procedure. We also aimed to reduce CT/MRI technologist search time for implant information in the EMR to ≤ 5 minutes. Read More

Authors:  Givler Nicole , Gouge Laura , Vogel Daniel , Averill Lauren

Keywords:  implant documentation, continuous improvement, interdisciplinary

Harris Debra,  Maniyar Jenny,  Dixon Rachel,  Kapadia Tejas

Final Pr. ID: Poster #: CR-022

1. The overall incidence of Mullerian Duct anomalies (MDAs) has been estimated as approximately 5 percent in the general population and higher in those with pregnancy loss. The categories of MDAs are seven-fold.
2. OHVIRA – obstructed hemivagina and ipsilateral renal agenesis is a class 3 MDA. We will describe imaging appearance of OHVIRA. This rare condition includes uterine didelphys, haematocolpos and ipsilateral renal agenesis.
3. This poster will explain the embryogenesis and interdependence of the urinary and reproductive systems.
4. We will highlight that early detection and diagnosis is key to prevent worsening of symptoms by the time of puberty.
5. We will demonstrate the importance of scan technique which, at our institution, includes a 3D turbo spin echo (SPACE™) acquired in the coronal plane with the ability to reformat in all three planes to produce a superior high-resolution sequence to analyse small structures.
6. We provide high quality imaging from several cases of this particular MDA at our institution for this poster. Read More

Authors:  Harris Debra , Maniyar Jenny , Dixon Rachel , Kapadia Tejas

Keywords:  Mullerian Duct Anomalies, Improvement

Rigsby Devyn,  Lenehan Patrick,  Gupta Alejandro,  Lorusso Jessica,  Sagar Pallavi

Final Pr. ID: Poster #: SCI-023

Health system integration presents challenges for radiology departments, especially in standardizing imaging protocols across new affiliate sites. In pediatric radiology, these challenges are amplified when adult-focused centers begin serving children, as pediatric imaging often requires protocol modifications. Per ACR-SPR-SSR guidelines, pediatric dual-energy x-ray absorptiometry (DXA) should include lumbar spine and total body images, which provide a more accurate measurement of bone mineral density in children than the standard adult DXA protocol. In our integrated health system, radiologists noted inconsistent use of the pediatric DXA protocol at new affiliate sites. This quality improvement (QI) study evaluated adherence to pediatric DXA protocols across imaging sites to inform targeted interventions to improve national guideline compliance. Read More

Authors:  Rigsby Devyn , Lenehan Patrick , Gupta Alejandro , Lorusso Jessica , Sagar Pallavi

Keywords:  Quality Improvement, DEXA, Protocol

Yeo Zhi Jie Shaun,  Yap Hong Wan,  Belmonte Joy V,  Lee Wong,  Chiang Jayne,  Yap Te-lu,  Fortier Marielle V,  Tan Timothy Shao Ern

Final Pr. ID: Poster #: SCI-011

To evaluate the impact of an “ultrasound-first” pathway for suspected midgut malrotation/volvulus on diagnostic timeliness and outcomes. Read More

Authors:  Yeo Zhi Jie Shaun , Yap Hong Wan , Belmonte Joy V , Lee Wong , Chiang Jayne , Yap Te-lu , Fortier Marielle V , Tan Timothy Shao Ern

Keywords:  Quality Improvement, Malrotation, Volvulus

Harris Debra,  Maniyar Jenny,  Dixon Rachel,  Kapadia Tejas

Final Pr. ID: Poster #: EDU-054

Endometriosis remains an important cause of pelvic pain in menstruating individuals. At our tertiary Paediatric hospital, we have seen a year-on-year rise in requests to exclude endometriosis using MRI scan. This rise is reflective of the increased awareness around endometriosis widely published recently which includes the importance of the MDT to reach diagnosis and shape treatment i.e. medical and/or surgical. As a result of this, our institution has optimised the paediatric gynaecology MR protocols to better align with that of our adult colleagues to support the benign teenage gynaecology clinic recently merged within our services since 2022 to achieve smooth transition from paediatric to adult services. The limitations of diagnosing endometriosis are widely published, and scans are performed to detect those signal changes which directly but also indirectly indicate endometriosis. For instance, direct signs may be adenomyosis, focal plaques or endometriotic deposits whilst indirect signs would be those related to adhesions, ovarian position, haematosalpinx etc. Out of this cohort we present salient findings in adolescent endometriosis using our enhanced imaging protocol which includes narrow field of view, axial, coronal and sagittal fast spin echo T2, axial T1 with and without fat saturation, an axial T2 fat saturated sequence and diffusion weighted imaging. The latter added to characterise any suspicious adnexal lesions. In comparison to the adult service, we do not use intravaginal gels in children. We do not include contrast or buscopan to facilitate scan time, reduce potential side effects and eliminate needle usage in younger patients. As reporters, we regularly attend the Endometriosis MDTs held at our institution to develop our skills. Using our inbuilt secure chat and messaging system we are now in better contact with our gynaecology colleagues. To build on this soon we aim to set up our own adolescent benign gynaecology meeting. Read More

Authors:  Harris Debra , Maniyar Jenny , Dixon Rachel , Kapadia Tejas

Keywords:  Magnetic Resonance Imaging MRI, GU, Improvement

Harris Chris

Final Pr. ID: Poster #: SCI-001 (R)

Background: Brain MRI has become an integral tool in the diagnosis and management of neonates with possible brain injury. In a large quaternary care neonatal intensive care unit (NICU), MRIs are routinely performed for the identification of white matter lesions in preterm infants, prognostication in hypoxic ischemic encephalopathy, peri-operative evaluation of patients with meningomyeloceles and hydrocephalus among other indications. Patients are often sedated in order to obtain high quality images, but sedation comes with complications. As these studies become an integral part of our practice in the NICU, we have identified a need to minimize the use of sedation to obtain clinically acceptable neonatal brain MRIs. Read More

Authors:  Harris Chris

Keywords:  Quality Improvements, Reduce Sedation, MRI brains

Shah Summit,  Krishnamurthy Ramkumar,  Kelleher Sean,  Krishnamurthy Rajesh

Final Pr. ID: Poster #: SCI-029

Two major insurance companies have recently enacted policies requiring outpatient advanced imaging at free-standing imaging facilities for adults. Examining the potential clinical and economic implications of non-subspecialized interpretations in children is important. We evaluated the rate of major discrepancies and changes in management arising from second interpretations by a dedicated pediatric facility. Read More

Authors:  Shah Summit , Krishnamurthy Ramkumar , Kelleher Sean , Krishnamurthy Rajesh

Keywords:  Healthcare Policy, Reimbursement, Quality Improvement